Provider Demographics
NPI:1235570995
Name:UNIVERSITY OF MASSACHUSETTS AMHERST
Entity Type:Organization
Organization Name:UNIVERSITY OF MASSACHUSETTS AMHERST
Other - Org Name:PSYCHOLOGICAL SERVICES CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:OVERTREE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:413-545-0041
Mailing Address - Street 1:135 HICKS WAY
Mailing Address - Street 2:SUITE 123
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01003-9271
Mailing Address - Country:US
Mailing Address - Phone:413-545-0041
Mailing Address - Fax:413-577-0947
Practice Address - Street 1:135 HICKS WAY
Practice Address - Street 2:SUITE 123
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01003-9271
Practice Address - Country:US
Practice Address - Phone:413-545-0041
Practice Address - Fax:413-577-0947
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-10
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty